The purpose of this revised research career award is to attain the necessary theoretical, statistical, and methodological background to develop as an independent investigator in adolescent health and intervention research. The K-01 will support training in advanced statistics and methodology at Johns Hopkins University, clinical training, mentored relationships, and empirical research to position the candidate to independently conduct intervention research with HIV positive and at-risk adolescents. In addition, the specific aims of this award will be accomplished. The specific aims of the study are: (1) to determine the role of PTSD in pathways linking abuse to sexual risk behaviors in HIV positive female adolescents with abuse histories; (2) to conduct qualitative interviews with HIV positive female adolescents to a) identify functional relationships and cognitive themes linking PTSD, substance use, and sexual risk behavior and b) identify prefer red delivery strategies for the intervention; and (3) to use information gathered in the quantitative and qualitative analyses to design, pilot, and refine an intervention (Trauma Focused Cognitive Behavior Therapy, TF-CBT) targeting PTSD, substance use, and sexual risk behavior in female adolescents with HIV.